“Erotic” and “vomiting” are not words that appear together often—and fortunately so, for most of us. Orgasms and barfing are strange bedfellows, even natural enemies, you might say. Yet when it comes to human sexuality, subjectivity is the most critical ingredient in the alchemy of arousal, and there are rare individuals, believe it or not, whose most intense desires involve the gratuitous expunging of their own or others’ intestines.

And it’s not just a sort of one-off, dubiously kinky act (what’s known in the circus world of extreme porn as—and apologies in advance to Romans—“Roman showers”). To the contrary, emetophilia seems to be a very unusual, but also very real, paraphilia. At least, that’s according to the psychiatrist Robert Stoller, whose 1982 article on the subject remains the only published scientific account on record.

In his stomach-turning paper, Stoller described the cases of three supposed emetophiles, all of whom, interestingly enough, were women. The first vomiter was bisexual and in her forties. “Labeling her a vomiter implies that she feels the symptom to be part of her identity,” explains the author, “not just an occasional experience.” As anyone who has ever hugged a toilet after being stricken by the flu, made the mistake of eating a lukewarm hotdog in a rural gas station, or imbibed too much vodka will know all too well, the act of vomiting—at least, the immediate aftermath—can be immensely relieving. But this woman’s frequent “dumping,” as she called it, seemed to offer her a euphoria comparable to intense psychotropic bliss. “When I begin to vomit, I get a rush,” she told Stoller:

I don’t put needles in my arm because I get those sensations and much more from simple vomiting … I enjoy vomiting. It’s something I’ve done all my life, but it didn’t really become pleasurable until after I had my first baby.

Erotic vomiting came quite naturally to her, with her volatile stomach being easily triggered by any type of intense emotions—including strong sexual stimulation. But while these “volcanic” episodes, as Stoller describes them, might have delivered mind-blowing climaxes for her, it’s hard not to feel sorry for her (presumably) unsuspecting partners. Their pleasure, after all, must surely have wilted upon this bizarre experience, their stomachs returning the favor with a hasty vacating of their own. (It also can’t be very good for your self-esteem to induce vomiting in your partner while undressing or receiving oral sex. “You make me so hot I’m going to throw up,” is not exactly standard pillow talk, after all.)